摘要目的 探讨糖尿病肾病(DN)的相关危险因素及糖尿病性皮肤病(DD)对DN的筛查价值.方法 选择188例2型糖尿病(T2DM)患者,其中合并DN者78例(DN组),无DN者110例(非DN组).记录并比较两组患者的性别、年龄、糖尿病病程、吸烟情况、DD、体质量指数(BMI)、收缩压(SBP)、舒张压(DBP)、空腹血糖(FBG)、餐后2h血糖(2 h PG)、三酰甘油(TG)、总胆固醇(TC)、糖化血红蛋白(HbA1c)、空腹C肽(FC-P)等.以有无DN为因变量进行多因素Logistic回归分析.结果 T2DM患者中DD与DN的发病率分别为47.34％(89/188)和41.49％(78/188).而DN组中DD的发病率达79.49％(62/78),而非DN组中为24.55％(27/110),两组比较差异有统计学意义(P＜0.05).DN组患者年龄、糖尿病病程、SBP、FBG、2 h PG、HbA1c明显高于非DN组[(52.83±6.43)岁比(50.35±6.48)岁,(10.51±4.36)年比(6.48±3.25)年,(137.42±14.17) mmHg(1 mmHg=0.133 kPa)比(132.57±15.38) mmHg,(11.95±2.83) mmol/L比(10.28±1.98) mmol/L,(15.07±3.16) mmol/L比(13.51±2.75) mmol/L,(9.62±2.17)％比(8.63±2.08)％],FC-P低于非DN组[(1.76±0.89) μg/L比(2.01±0.72) μg/L],差异均有统计学意义(P＜0.05).多因素Logistic回归分析结果显示,糖尿病病程、DD、FBG是影响DN的独立危险因素(OR=4.841,3.209,3.368,P＜0.01).结论 在T2DM患者中,DD与DN存在一定的相关性.对于T2DM患者存在DD时应注意DN的筛查.

abstractsObjective To explore the related risk factors for diabetic nephropathy(DN) and discuss the value of diabetic dermopathy (DD) screening for DN.Methods A total of 188 patients with type 2 diabetes mellitus (T2DM) were studied,which included 78 patients with DN (DN group) and 110 cases without DN (non-DN group).The sex,age,duration of diabetes mellitus,smoking,DD,body mass index (BMI),systolic blood pressure (SBP),diastolic blood pressure (DBP),fasting blood glucose (FBG),2hours postpradial glucose(2 h PG),triglyceride (TG),total cholesterol (TC),glycosylated hemoglobin A1c (HbA1c),fasting C-peptide(FC-P) were recorded.Multiple factor Logistic regression was applied in patients with DN and non-DN.Results The incidence of DD and DN in T2DM patients was 47.34％(89/188) and 41.49％ (78/188) respectively.The ratio of DD in DN group was 79.49％(62/78),in non-DN group was 24.55％ (27/110),and the difference was significant (P ＜ 0.05).The age,duration of diabetes mellitus,SBP,FBG,2 h PG,HbA1c in DN group was higher than that in non-DN group [(52.83 ± 6.43) years old vs.(50.35 ±6.48) years old,(10.51 ±4.36) years vs.(6.48 ±3.25) years,(137.42 ± 14.17) mmHg(1mmHg =0.133 kPa) vs.(132.57 ± 15.38) mmHg,(11.95 ±2.83) mmol/L vs.(10.28 ± 1.98) mmol/L,(15.07 ± 3.16) mmol/L vs.(13.51 ± 2.75) mmol/L,(9.62±2.17)％ vs.(8.63 ± 2.08) ％],FC-P was lower than that in non-DN group [(1.76 ± 0.89) μ g/L vs.(2.01 ± 0.72) μ g/L],and the difference was significant (P ＜ 0.05).Multiple factor Logistic regression analysis showed that duration of diabetes mellitus,DD and FPG were still related to DN in T2DM (OR =4.841,3.209,3.368,P ＜0.01).Conclusions DD is correlated with DN in T2DM.DN should be screened in T2DM patients with DD.